Organization Active NPI

Marceca Chiropractic Center PC

  • Medical Specialty Clinic/Center
  • Fayetteville, GA
National Provider Identifier
1043587280
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
CHIR002314 Issued in GA
Legal business name
MARCECA CHIROPRACTIC CENTER PC
Practice address
123 Ellis Rd
Suite a
Fayetteville, GA 30214-1842
Phone
(770) 461-7664
Fax
(770) 461-1676
NPI assigned
Nov 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michael Al Marceca, D.O.NPI 1699765248
Title
Owner
Phone
(770) 461-7664

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X CHIR002314 GA Primary

Addresses

Primary practice location

123 Ellis Rd
Suite a
Fayetteville, GA 30214-1842

Mailing address

123 Ellis Rd
Suite a
Fayetteville, GA 30214-1842
Phone (770) 461-7664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111129000249 GA Part B Supplier - Clinic/Group Practice 9638343759 Receives reassigned benefits from 1 practitioner
Practice locations: Fayetteville, GA

National Provider Directory

National Provider Directory

Locations

123 Ellis Rd
Ste A
Fayetteville, GA 30214
Phone (770) 460-6193

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714953600000",
    "number": "1043587280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 ELLIS RD",
            "address_2": "SUITE A",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141842",
            "telephone_number": "770-461-7664",
            "fax_number": "770-461-1676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 ELLIS RD",
            "address_2": "SUITE A",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141842",
            "telephone_number": "770-461-7664",
            "fax_number": "770-461-1676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCECA CHIROPRACTIC CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-16",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A",
        "authorized_official_last_name": "MARCECA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "AL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-461-7664",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "GA",
            "license": "CHIR002314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.